HealthNow Healthcare is Medicare certified by the federal government. The Medicare program can help pay for the in-home healthcare needs of eligible patients. HealthNow work with referral sources to see if patients meet Medicare’s criteria.
We work with patients and their families to offer home healthcare in private pay or self-pay scenarios. Insurance plans may not cover all of the services that you require, or discontinue them sooner than expected. To receive the services, private or ‘out-of-pocket’ payments can be made to cover the difference.
Commercial Insurance/Managed Care/Third Party Payers
HealthNow is always working at growing their Managed Care Contracts and has developed policies to effectively work in managed care settings. Contact your local HealthNow office if you have questions of whether your insuring will cover home healthcare.
Who is Eligible?
People with Part A or Part B that meet all of the following criteria are covered:
- You must be under the care of a doctor, and you must be getting servic es under a plan of care established and reviewed regularly by a doctor.
- You must need, and a doctor must certify that you need, one or more of these:
- Intermittent skilled nursing care (other than just drawing blood)
- Physical therapy, speech-language pathology, or continued occupational therapy services These services are covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally-predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition.
- The home health agency caring for you must be Medicare-certified.
- Your must be homebound, and a doctor must certify that you’re homebound
- You must currently be under the care of a doctor and being serviced under a regularly reviewed plan that they developed.
- A doctor must certify that you need one or more of the following:
- Intermittent skilled nursing care (not including blood drawing)
- Physical therapy, speech-language pathology or continued occupational therapy services. These are only covered if they are a specific, safe and effective treatment. The amount and frequency of treatment needs to be reasonable and only qualified therapists may do them safely and effectively. To be eligible, either:
The home care health agency must be Medicare-certified.
A doctor must certify that you are homebound.
- your condition must be expected to improve in a reasonable and generally-predictable period of time,
- you need a skilled therapist to safely and effectively make a maintenance program for your condition, or
- you need a skilled therapist to safely and effectively do maintenance therapy for your condition.
If you need more than part-time or ‘intermittent’ nursing care, you are not eligible for the home health benefit.
You may leave home for medical treatment or short infrequent absences like religious services. If you attend adult day care, you can still get home health care.
***Note*** Home health services can include part time or intermittent medical social services as well as home health aide services. Durable medical equipment and injectable osteoporosis drugs may also be provided.
Your Original Medicare Costs
- $0 for home health care services
- 20% of the Medicare approved amount for durable medical equipment
The home health agency should tell you how much Medicare will pay before the home health care begins. The agency should also tell you if any items or services aren’t covered, as well as much you will pay for them. This should be detailed verbally and in writing. The agency should give you a “Home Health Advance Beneficiary Notice” (HHABN) before delivering supplies or services that are not covered by Medicare.